Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Nov;134(5):855-66.
doi: 10.1542/peds.2013-3319.

Prevalence and characteristics of fetal alcohol spectrum disorders

Philip A May  1 , Amy Baete  2 , Jaymi Russo  2 , Amy J Elliott  3 , Jason Blankenship  4 , Wendy O Kalberg  4 , David Buckley  4 , Marita Brooks  4 , Julie Hasken  5 , Omar Abdul-Rahman  6 , Margaret P Adam  7 , Luther K Robinson  8 , Melanie Manning  9 , H Eugene Hoyme  3
Affiliations
Randomized Controlled Trial

Prevalence and characteristics of fetal alcohol spectrum disorders

Philip A May et al. Pediatrics. 2014 Nov.

Abstract

Objectives: To determine the prevalence and characteristics of fetal alcohol spectrum disorders (FASD) among first grade students (6- to 7-year-olds) in a representative Midwestern US community.

Methods: From a consented sample of 70.5% of all first graders enrolled in public and private schools, an oversample of small children (≤ 25th percentile on height, weight, and head circumference) and randomly selected control candidates were examined for physical growth, development, dysmorphology, cognition, and behavior. The children's mothers were interviewed for maternal risk.

Results: Total dysmorphology scores differentiate significantly fetal alcohol syndrome (FAS) and partial FAS (PFAS) from one another and from unexposed controls. Alcohol-related neurodevelopmental disorder (ARND) is not as clearly differentiated from controls. Children who had FASD performed, on average, significantly worse on 7 cognitive and behavioral tests and measures. The most predictive maternal risk variables in this community are late recognition of pregnancy, quantity of alcoholic drinks consumed 3 months before pregnancy, and quantity of drinking reported for the index child's father. From the final multidisciplinary case findings, 3 techniques were used to estimate prevalence. FAS in this community likely ranges from 6 to 9 per 1000 children (midpoint, 7.5), PFAS from 11 to 17 per 1000 children (midpoint, 14), and the total rate of FASD is estimated at 24 to 48 per 1000 children, or 2.4% to 4.8% (midpoint, 3.6%).

Conclusions: Children who have FASD are more prevalent among first graders in this Midwestern city than predicted by previous, popular estimates.

Keywords: alcohol use and abuse; children with FASD; fetal alcohol spectrum disorders; prenatal alcohol use; prevalence; women.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Diagnostic guidelines for specific FASDs, according to the Institute of Medicine, as clarified by Hoyme et al 2005.
FIGURE 2
FIGURE 2
Sampling methodology for prevalence of FASD in a Midwestern city.
FIGURE 3
FIGURE 3
Total dysmorphology scores by diagnostic category for a Midwestern city study.
FIGURE 4
FIGURE 4
Child cognitive/behavioral test performance centiles by diagnosis in a Midwestern city.
FIGURE 5
FIGURE 5
Final estimate of prevalence of FASD in a Midwestern city.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jones KL, Smith DW. Recognition of the fetal alcohol syndrome in early infancy. Lancet. 1973;302(7836):999–1001 - PubMed
    1. Robinson GC, Conry JL, Conry RF. Clinical profile and prevalence of fetal alcohol syndrome in an isolated community in British Columbia. CMAJ. 1987;137(3):203–207 - PMC - PubMed
    1. May PA, Hymbaugh KJ, Aase JM, Samet JM. Epidemiology of fetal alcohol syndrome among American Indians of the Southwest. Soc Biol. 1983;30(4):374–387 - PubMed
    1. May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health. 2001;25(3):159–167 - PMC - PubMed
    1. May PA, Gossage JP, Kalberg WO, et al. . Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev. 2009;15(3):176–192 - PubMed

Publication types